My guest this week is Mead Over, one of the world’s leading experts on the global response to the HIV/AIDS pandemic. We discuss his new book, Achieving an Aids Transition: Preventing Infections to Sustain Treatment. The key idea is simple but powerful. Mead argues that, instead of reaching vainly for the unsustainable goal of offering treatment to everyone in the developing world who needs it, donor policy should aim to sustain current treatment levels while reducing the number of new infections below the number of AIDS deaths, so that the total number of people with HIV/AIDS declines.
“The escalating number of people infected with HIV/AIDS is far outpacing available funding for treatment, especially in Africa,” Mead tells me. “Only by holding deaths down and preventing new infections will the total number of people with HIV decline and an AIDS transition be reached.”
Despite the billions of dollars spent on the disease, he says, the number of people infected has continued to climb. In recent years, about 1.8 million people have died each year from AIDS-related illnesses. Meanwhile, 2.6 million people become newly infected. So each year an additional 800,000 people are HIV positive.
About 33 million people are now infected with the Human Immunodeficiency Virus, roughly twice as many as 15 years ago, when the international community began to organize against the epidemic. Of the 16 million whose disease has progressed to the point where they should be receiving treatment, only six million are receiving the medicines they need.
Mead says that making an AIDS transition an explicit goal of the international response to the epidemic would result in changes at many levels, for donor agencies, recipient countries and even health practitioners. At the end of the Wonkcast we discuss new medical research showing that treatment has significant prevention benefits, and the implications of this important finding for how countries can attain an AIDS transition.